Laserfiche WebLink
��� APPLICATI�•�1 FOR CONSTRUC7�N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> HEATING SYSTEM: U GAS U ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I i DEMOLITION fJ COMBINATION �BUILDIHG 'I I MECHANICAL I I PLUMBING I i SIGN <br /> cm nr r� <br /> �i�� �ae�sa� ��OGI� S'/�ft?�/�►'E �c�o��r >d'�e 3.�'/7�SL/ <br /> TENIINT MARIIDDNE55 CITY ZIP ��E <br /> ARCXITEGTORDESIGNER MAILADDRE55 CITY ZIP �E . <br /> P. 7r � T` �ld �avas ��O zo 7��`'—9�5 0 _ <br /> pA�00NTMCTOR M�ILADDi1E55 CIiY ZIV P�IdIE ST�TELICENSE/ <br /> ' {� .T L'Gu/�l-37�� <br /> MECMAH�G�LCONTM�TOR 1MRMD�E55 CITY 21P PIqNF STIIIELICENSE/ <br /> p��J�IgINp CONTRACTOR MAIL ADDRESS CITY 21P P��E STATE IILENSE� <br /> GUSS OF Wd�R <br /> I I NEW AD�ITION I I ALTERATION I 1 REPAIR I I DEMOLITION I I WOODSTOVE/FRPLINSERT I I BUIlDIN6RElOCATION <br /> con��cT nsoa�rro rr�or+e ���� G <br /> CONTRACTPRICEOFWpM I OOO Q�FGS � 'L6.2� �vSU <br /> OESCRIBE YIJN(uA�(yq"AE FOOTAGE INVOL U <br /> rnoroseouseoFeutiox+a� �/ � /�X�b � i HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS <br /> s"1�� APPLICATION AND KNOW THE SAME TO BE TAUE AND CORRECL ALL � <br /> IEG/�LOESGP�PTIONO�PROPEATY�SIq'M�BE�OWO��T7ACHFWR�AP�ES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISiYPEOF <br /> WORK WILL BE COMPLETED WI1H WHE71iER SPECIFIED HEREIN OR <br /> �oT�_ eiocK oF F�F�i�+Oa" NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOIATE OR CANCEI THE PROVISIONS OF �NY <br /> OTHER STATE OR LOCAL LAW REC�UUTING CONSTRUCTION OR TNE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUT}K)RIZED BV THE <br /> � y 33� _ aa e_ o t g- c z OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTqf1S LAW 1827 RCW AND 296.Nq WAC. . <br /> .�r X {��..- �Lf,� �'�/� 'L <br /> /G <br /> oae <br /> VROJEGTAWPESS <br /> GItY ARNE64L1LENSE ND. <br /> ��s�N� MECNANICAL � <br /> Np, TYPE OF flXTURE OR ITEM FEE TYPE OF EOUIPMENT �E <br /> WATER CLOSET(TOILET) - � AI�AIHNDLG UNITS—H.P. . � <br /> BATHTUB ' FORCED AIR SYuTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEATERS--B.T.U. M � <br /> � CLOTHES DRYEHS ' <br /> � KITIiCHEN SINK 6 DISP � VENTILATION FAN � <br /> 4 DISHWASHER � RANGE HOOD ' <br /> UUNDHY TRAY ; WATER HEATER � <br /> i CLOTHES WASHER � WOOD STOVE ' <br /> URINAL ' METAL FIREP CE 8 CHIMNEY � � <br /> � DRINKIN6 FOUNTAIN � FIREPLACE INSERT � <br /> � FLOOR DRAIN � HEAT PUMP � <br /> BACKFIOW PREVEN RS ; GAS PIPINO <br /> ROOF DMIN NLEADERS � E%HAUST FAN ' <br /> � <br /> � SINK(SERVIC AR,ETC.) � � <br /> � <br /> � <br /> � � <br /> � <br /> � ' <br /> SUBTOTAL S <br /> i SUBTOTAL S ' <br /> PERMIT S � PERMIT f � <br /> � TOTALFEE f ' TOTALFEE S ' ' - <br /> QR OFFlCE USE ONLY: <br /> FRONT SET&1CK AEAR SETBACK S�DE SE7B�CK PLAN GNECN NUMBER FEE RECCR'T N0. 3 <br /> ZS' 7�5� ``�✓ 7.5 .3Gii �77s' G33 � <br /> usez LOTAflEl^17 vac�r+rsi� FEES VALUATION �E <br /> 'S Z ` � � BUILDING IZ � _�� � �� <br /> TYI'EO�CONi6./�IIOWMIE TYPFOiCON51.AC7VAL a%1M�Mtr M���tlmGlMnS � � <br /> i <br /> ,�/� u/�, ° ° � PLUMBINO _��_ <br /> M � <br /> S�g�g�pp, NO.OF SiORIES BASEMEnT MECHANICAL � <br /> � ' � � �' ADDITIONAI PLAN CHECK � <br /> OCCUP/�NCYLO�D FIRESPRNKLENSREOD HEIONniII�rAIT�710N �— <br /> � NU C!^ SPRINNLER � <br /> RE�SONiORSPRttJ1(lERS L� ��/.. <br /> STATE BUILDING SUACHARGE � <br /> __ -- � <br /> INiA1cE BY PU1NS�PPROVEO BY CITY OF EVERETT PUBLIC WORK$ �-r <br /> � LOCIIL SALES � <br /> L 92 J TAX CODE IS 3105 �OTAI /.�9 �� <br />